Meeting Attendance: Steve Brooks, Chair, Monterey Lisa Madrid, Chair-Elect, Riverside John Poland, Secretary, S-SV Alameda: Central California: Coastal Valleys: Contra Costa: Craig Stroup El Dorado: EMSA: ICEMA: Imperial: Kern: Los Angeles: Susan Mori Marin: Merced: Monterey: Steve Brooks Mountain Valley: Lance Doyle Napa: Shaun Vincent North Coast: Northern California: Orange County: Riverside: Lisa Madrid Sacramento: San Benito: San Diego: Susan Smith San Francisco: San Joaquin: Rick Jones San Luis Obispo: Kathy Collins San Mateo: Santa Barbara: Santa Clara: Chris Duncan, Linda Diaz Santa Cruz: S-SV: John Poland Solano: Sonoma: Tuolumne: Ventura: Karen Beatty Yolo: Agenda Item Discussion Action/ Comments 1. Welcome, Introductions, Roll Call Meeting called to order at 1305 hours. Roll call of attendees 2. Minutes Review and approve July 27, 2017 meeting minutes. Minutes approved by consensus 3. CQI Best Practices Conference Item was moved up on the agenda due to Craig Stroup needing to leave the meeting early. Craig indicated that he envisions a full day conference with 4 5 LEMSA best practice presentations. Presentations would be CQI oriented and data driven. Conference would be geared toward LEMSA personnel but Committee agreed to attempt Sept. 2018 conference scheduling 09/28/2017 Page 1 of 5
would also be opened up to prehospital providers. The committee discussed the need for appropriate time to plan as well as identifying a date and location for the conference. Craig mentioned March 2018 or June 2018 as possible dates to consider. Following additional discussion, the committee agreed that September 2018 would be acceptable and Susan Mori indicated that she would check on availability of the California Endowment Center in downtown LA as a possible venue. Steve Brooks stated that he would send out a survey to the LEMSAs to determine the level of interest in attending the proposed conference. Additional discussion will occur at the next meeting. Note: Craig also advised the committee that he was retiring from the Contra Costa County EMS Agency at the end of the month. Craig indicated that he would still be around and planned to continue to participate in QI activities. Jesse Allured would be the official committee representative for Contra Costa. 4. California Core Measures Continuation of discussion from the last meeting on the challenges/concerns with the California Core Measures in their current format. Most LEMSAs continue to have concerns about the effectiveness and usefulness of the current core measures and believe it would be beneficial to focus on a smaller number of core measures to improve data validity and reliability. Based on previous discussion, there does not seem to be a desire from EMSA to make significant changes to the current core measures process that has been in pace for the past several years. The committee also discussed some of the challenges related to the data transition from NEMSIS Version 2 to NEMSIS Version 3 that occurred earlier this year. Craig to work on identifying possible presentations Steve to survey LEMSAs to determine level of interest Susan to determine availability of a venue for the conference Item will remain on the agenda Steve Brooks will request EMSA representatives to provide an update during the December face-toface meeting The committee agreed to leave this item on the agenda for additional discussion and to monitor the process. Steve Brooks will ask EMSA representatives to provide an update on the core measures project and the EMS data system during the December 5, 2017 face-to-face meeting. 09/28/2017 Page 2 of 5
5. Committee Guidelines Continuation of the discussion from the last meeting. Committee guidelines are due for review and updating. Guidelines were previously sent out to the committee for review and proposed changes were incorporated. 6. Committee Goals: 2017-2018 Following additional discussion, the committee agreed that there should be an additional section to address liaison/emeritus/ex-officio members (EMSAAC & EMSA representatives, previous LEMSA members who are interested in continuing to provide consultation, etc.). The 2017/2016 goals were approved at the May meeting. Steve Brooks felt that it would be beneficial to add additional language addressing specific measurable goals. First Objective: Continue working relationships with EMSAAC, EMDAC and EMSA to provide subject matter expertise and consultation on CQI issues. o Added Goal Work group to evaluate specified Core Measures and recommend changes or process improvement. o Addressed during the core measures discussion earlier in the meeting. Second Objective: Foster Just Culture and promote a safe environment for EMS constituents in regards to CQI efforts. o Added Goal Develop and pilot a Patient Safety Boot Camp. o Committee agreed that this was still an important goal, but Boot Camp funding needs to be identified before moving forward. Susan Mori will continue to work on this item. Third Objective: Develop and promote professional standards for EMS CQI professionals. o Committee agreed that it would be helpful to develop a CQI guidebook containing Q & A and best practices information that could be made Steve will add recommended membership language Will be on the next meeting agenda for approval Committee members will continue to work on these items and report back to the committee as appropriate Steve to survey LEMSAs regarding barriers to their participation 09/28/2017 Page 3 of 5
available for new QI coordinators as a training resource. Steve Brooks will solicit input from other committee members on this item. Forth Objective: Increase LEMSA participation in the California LEMSA CQI Committee. o Participation from some LEMSAs has been a continuing concern. Previous attempts to increase participation have had limited success. It was suggested that it may be helpful to survey the LEMSAs to determine barriers to participation. It was also suggested that changes to the meeting format may also assist in encouraging additional participation (asking individual LEMSAs to present specific QI related items/best practices, having additional visuals to discuss/follow along with for the meetings, etc.). Fifth Objective: Develop, organize and conduct a CQI best practices symposium. o Addressed during the CQI Best Practices Conference discussion earlier in the meeting. 7. APOT No specific updates or discussion related to this item. Committee agreed to remove this item from the agenda. 8. QI Topics Roundtable The following roundtable topics were discussed by the committee: Paramedic Ketamine Trial Study: Question by Lisa Madrid. Lance Doyle indicated that the MVEMSA trial study request had been recently approved but they have not received a formal approval letter from EMSA yet. Standardized trial study protocols have been developed/approved for pain management only. Trial Study will be implemented once formal approval is received. Lance believes this trial study will be available for all LEMSAs interested in participating, but they will need to utilize the approved/standardized protocol and provide data to MVEMSA for tracking and compiling. Committee agreed to remove this item from the agenda. Discussion items John to send pediatric intubation presentation documents to committee 09/28/2017 Page 4 of 5
There was a discussion at the September EMDAC meeting regarding paramedic optional skills utilization of pediatric intubation. According to the meeting minutes, the EMSAC Scope of Practice Committee is recommending that the skill be removed from the paramedic optional scope of practice statewide. Several California LEMSAs have already removed it. John Poland will send out the PowerPoint and literature regarding this item that was discussed at the EMDAC meeting. Ventura County announced that they will go live on Monday with their Thrombectomy Capable Stroke Receiving Center hospital designations. The Joint Commission will be adding this as a new stroke center certification level beginning January, 2018. Ventura County was ahead of The Joint Commission on this as it was unknown when the certification process would be available. The hospital requirements that Ventura County developed closely align with The Joint Commission certification requirements that were just released. 9. Next Meeting December 5, 2017 (in conjunction with the quarterly EMSAAC meeting). Faceto-face meeting with possible conference call capabilities for members unable to attend in person. Meeting will be held in the Heritage Room at the Marines Memorial Club and Hotel from 10am 4pm. 10. Adjournment and Roll Call Meeting adjourned at 1440 hours Steve will send out a reminder for the December meeting 09/28/2017 Page 5 of 5